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Epilepsy, suicidality, and psychiatric disorders: a bidirectional association
Dale C Hesdorffer1, Lianna Ishihara, Lakshmi Mynepalli
1Gertrude H. Sergievsky Center and Department of Epidemiology, Columbia University, New York, NY 10032, USA. dch5@columbia.edu
Annals of Neurology
|August 14, 2012
Summary
People with new epilepsy diagnoses have higher rates of psychiatric disorders and suicide attempts. These findings suggest shared biological causes for epilepsy and mental health conditions, impacting seizure threshold and suicide risk.
Area of Science:
- Neuroscience
- Psychiatry
- Epidemiology
Background:
- Epilepsy is a chronic neurological disorder.
- The relationship between epilepsy and psychiatric comorbidities, including suicidality, requires further investigation.
Purpose of the Study:
- To determine if psychiatric disorders and suicide are more prevalent in individuals with incident epilepsy compared to matched controls.
- To examine these associations before and after epilepsy diagnosis.
Main Methods:
- A matched, longitudinal cohort study using the UK General Practice Research Database.
- 3,773 epilepsy cases were compared to 14,025 controls.
- Analysis of psychosis, depression, anxiety, suicidality, and suicide attempts in the 3 years preceding and following epilepsy diagnosis.
Main Results:
- Significantly increased incidence rate ratios (IRR) for psychosis, depression, and anxiety were observed both before and after epilepsy diagnosis.
- Increased IRR for suicidality was found before epilepsy diagnosis and one year after.
- Elevated prevalence ratios (PR) for suicide attempts were noted before and after epilepsy onset.
Conclusions:
- Epilepsy is linked to a higher incidence of psychiatric disorders and suicide.
- These associations suggest common pathophysiological mechanisms underlying epilepsy, psychiatric conditions, and suicide risk.
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